Montana hospitals hit hard by Veterans Choice not paying bills

MISSOULA, Mont. - The Veterans Choice program is meant to let veterans in rural areas go to private doctors instead of driving miles to a Veterans Affairs clinic.

Here's how the process works:

The VA determines if a veteran is eligible. A contractor called HealthNet gets that information and sends the veteran a card. Then the veteran either contacts HealthNet to make appointments or the VA tells HealthNet to contact the veteran. HealthNet confirms the eligibility, makes the appointment and then passes the bills to Veterans Choice to pay.

But here's the catch. Veterans Choice is behind in its payments.

This isn't the way the system's supposed to work. Just two years ago, U.S. taxpayers shelled out over $17 billion for a deal to fix a scandal -- a backlog of veterans waiting for care.

President Obama signed the bill on July 28, 2014. Part of it included $10 billion for Veterans Choice, under the Veterans Health Administration. It means veterans could get treatment at private hospitals on the government's dime.

Fast forward two years. The fix now seems to need a fix of its own. Veterans say Veterans Choice is slow to schedule appointments. Hospital and clinic administrators tell us it's often even slower paying bills.

Just ask Deb Green at Mineral Community Hospital. Veterans Choice hasn't paid $51,000 worth of bills. It's enough to make it tough for Green to balance the books.

"It is frustrating," Green said. "We are a very small hospital. We go week to week trying to make payroll and be sure our community survives. That money is important to us."

It is the same story in Ravalli County, home to roughly 5,000 veterans. There you will run into an even larger problem. Marcus Daly Hospital reports nearly $2 million left unpaid since last August by Veterans Choice.

Donja Erdman is the CFO for Marcus Daly. Erdman said, "We are going to care for veterans one way or another. It's just the funding mechanism that's broken."

It's so broken, Missoula Bone and Joint told us it stopped taking Veterans Choice patients in March. And now we've found a government study that concludes other clinics could do the same thing, if the problem doesn't get fixed.

The May 2016 Government Accountability Office report blames that delay on several things. On the list, a cash flow so badly managed there's sometimes no money to pay. Analysts also say there are few electronically submitted documents and bins of paper claims waiting to be processed.

It's just like what Bev Green always imagined. "I've got this vision of a great huge mail room and these claims," Green said. "They never get lost, but they end up in triplicate. They are copies of records that just keep stacking up and up."

That means the program created to help veterans, could end up hurting them.

It's already hurt veteran Larry Garrison. He can't go back to his orthopedic clinic, Missoula Bone and Joint. "They told me at the time they were going to quit taking Veterans Choice patients because Veterans Choice wasn't paying," Garrison said.

We shared the billing trouble and veteran's stories with Sen. Jon Tester. He said the VA is fixable. He says he's holding administrators accountable to get it done. He also says it will take more than promises to make him a believer.

"They told us they're going to do some things, like add more people to their call center and embed some people in Fort Harrison to make it so their service is better," Tester said. "But until I start hearing from veterans, until I start hearing from providers that things are getting better, what they've done is unacceptable and what they continue to do is unacceptable until I hear from the folks on the ground that things are getting better."

Tester says his new bill will improve access and fix VA shortcomings. Tester's bipartisan Veterans First Act passed unanimously out of committee in May.